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Adults, obese and otherwise

Sunday, February 12th, 2012

PIck well and cut back your waste/waist

In my last post I explained the concept and the math behind the body mass index (BMI) approach to evaluating if your weight was normal or not (your BMI is very  well in synch with the most scientific methods of determining body fat percentages). Now I want to expand on that a bit  with some recent statistics and some thoughts on how we can lose weight if we need to. Unfortunately, some of us have lots of extra pounds we should shed if we want to have our best shot at leading long, healthy lives.

The Feb 1, 2012 issue of JAMA had a number of interesting articles on obesity. I've previously mentioned several on childhood and adolescent obesity; today I'd like to zero in on two whose focus is American adults.

Four CDC staffers, led by Katherine Flegal, PhD, published the most recent statistics from a recurring national survey with the daunting acronym NHANES. This national health and nutrition survey (the E stands for examination) started in 1971, but from 1999 on has been released results in two-year cycles. The current article from the National Center for Health Statistics, looking at the 2009-2010 NHANES data had a little good news and lots of bad news.

After 1980, until the turn of the 21st century, the prevalence (scientific term for percentage) of obesity in our population kept zooming up. Now it appears to have leveled off. I guess that's something we should be happy about, except now over 35% of adults in this country are obese. Men and women have about equally high rates of obesity and men have caught up to women in this regard over the last twelve years. Some subsets, by sex and racial groups, are even more likely to be obese or very obese.

The worst news from this article was that no group--men, women, non-Hispanic whites, Hispanics or non-Hispanic blacks--had a decrease in the prevalence of obesity in this most recent data set.

So which exercise and diet should we try?

getting enough exercise is difficult when your joints hurt

Many adults report "No Leisure-Time Physical activity." Overall, more of us are exercising, but the data vary from state to state. Those who have arthritis, fifty million in the US, need special attention or are even more likely to get no exercise. The CDC has worked with the Arthritis Foundation to develop ideas for this huge group. Going back to my review of articles on youngsters, I think for the rest of us, we could begin with simple steps, parking at the far end of the parking lot and substituting some walking for part of our screen time as two examples.

Harvard Medical School's free online HEALTHbeat publication had a review of pros and cons of various diets in its Feb 7, 2012 edition. The bottom line still is if you want to lose weight, you must cut down on your calories. The Mediterranean-style emphasis on fruits and vegetables, unrefined carbohydrates, nuts, seeds and fish may be the most effective in reducing cardiovascular and diabetic risks.

My New Year's Resolution is to keep my weight under 150 pounds. I have to work at it as I like to eat, but most of the time I've stayed away from splurges.

How about you?

 

JAMA

 

 

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Posted in body mass index (BMI), Centers for Disease Control and Prevention (CDC), Complications of Obesity, coronary artery disease, diabetes type 2, Life Expectancy, Life extension, medically-oriented background info, Metabolic Syndrome, Obesity, Publications, Weight Loss | No Comments »

Adulthood: when your BMI is more important than your IBM (stock)

Thursday, February 9th, 2012

I do this at home, without clothes

In my last post I wrote about our upcoming generations and their obesity issues. Unfortunately, as you might have easily been able to predict, that carries over into adulthood. The same issue  (Feb 1, 2012)  of the Journal of the American Medical Association (usually called JAMA) had several articles on adults also. To begin with the National Health and Nutrition Survey (NHANES) looked at the body mass index (BMI) of men and women from 1999 through 2010.

"AARRGGHH" you say, "Why the hell should I care about whatever BMI is enough to try to understand it?"

Well, that's a tough question, I admit. But BMI is the standard way of deciding if a person is too thin, normal, overweight or obese. So let's give it a try.

Your BMI is a number calculated using your height and weight.  If you weight 250 pounds and you're a seven-foot tall basketball professional center player, you're unlikely to be obese. But if you're five foot, six inches tall, and don't exercise at all, like the adolescent I was reading about recently, you're far too heavy. In the first case, the athlete has a lot of muscle, whereas the youngster is almost certain to be carrying around a lot of excess fat.

For a long time physicians just weighed their patients. That plus eyeballing their bodies in an exam room works for most people. Then along came the BMI as one way of getting a little more scientific. I looked online for the history of the use of body mass index as I suspected it was "invented" by a European (it was). It certainly seems to me to favor the metric system. There it's easy to figure out your BMI; you divide your weight in kilos by your height in meters. It's much more complicated using pounds and inches (BMI = weight in pounds divided by height in inches squared and that number is multiplied by 703) The CDC explanation of BMI is helpful and also supplies a "widget" you can download and a calculator if you just want to bookmark the website.

height counts, for adults too

So now you've (hopefully) figured out your own BMI; What does it mean and how reliable is it?

First the numbers: most people with a BMI under 18.5 are skinny, underweight. That probably excludes a whole passle of long-distance runners. Most people with a BMI over 18.5 and under 25 are in the "normal" weight category. I used the CDC calculator and my number is 20.5. Most whose magic number is 25+ and less than 30 are overweight and almost anyone whose BMI is over 30 is obese. The teenager I mentioned above has a BMI of 40.

Okay, you say. Now what do I need to do once I know what category I'm in.

I'd start with the eyeball test. Do you have a roll around the middle? In early 2009, weighing only three pounds more than I had for twenty years, I clearly did. I made up my mind to do something about that excess flab, knowing that fat in the belly also implies arteries that are narrowing down.

After losing thirty pounds and keeping it off, I bounced up after the Superbowl and went back on my diet, i.e., consuming fewer calories. I went to a meeting last evening; there were lots of goodies, but I ate only carrots and cucumbers. This morning I'm at 148.2 pounds, smack dab in the middle of the three-pound "ideal weight" range I decided on.

Harvard Medical School just published a piece titled "Choosing the diet that will work for you." The central theme is cutting calories.

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Posted in balanced diets, body mass index (BMI), Complications of Obesity, JAMA, medically-oriented background info | No Comments »

Slim down those truckers

Wednesday, November 23rd, 2011

some truckers are relatively slender

I have two series of posts going, but couldn't resist the article I found in the New York Times while riding a recumbent bike in the gym. The title alone, "A Hard Turn: Better Health on the Highway," was enough to grab my attention.

The first story was typical, a trucker driving long hours every day, eating all the wrong foods, getting no exercise, gaining huge amounts of weight. I found the online abstract of a 2007 Journal of the American Dietetic Association article cited: long-haul truckers of necessity eat at truck stops and of 92 such truckers stopping at a Mid-eastern US truck stop nearly 86% were overweight and 56.5% were obese.

One of our family members used to be a truck driver and I've heard his stories of long days spent behind the wheel, eating greasy foods when he stopped. He's slimmer now and in better shape as his current employment allows him more exercise time and a choice of where and what to eat.

Now that insurance costs are rising sharply, the trucking firms are getting involved and the truckers themselves, there's over three million of them in the US, are coming to grips with the issue out of necessity. One group ran a blood-pressure screening clinic for 2,000 truckers at a truck show. Twenty-one were immediately sent to a nearby emergency room; one had a heart attack before reaching the hospital.

drive carefully around trucks like this

Trucks are involved in 400,000 accidents a year and 5,000 fatalities. I just watched a nearly eighteen minute video on how we, as drivers of passenger vehicles, contribute to those accidents; 70% are caused by the drivers of other vehicles (see link below). Yet many of the ones caused by trucker driver error occur because the trucker has a health problem or falls asleep.

http://www.sharetheroadsafely.org/cardrivers/Unsafe-Driving-Acts.asp

Some truckers are taking steps to decrease their weight and its accompanying risks for themselves and those who share the roads with them. A number of companies are helping (and perhaps finding a lucrative new client group). I just looked at a website for "Rolling Strong," and found a gym in my area that offers fitness programs for truckers. Others are joining Weight Watchers, a solid organization that my slender wife has belonged to for many years (she says she was "chunky" in high school) or creating their own programs for fitness: one carries a fold-up bike in his 18-wheeler and uses it whenever he stops for a break. Many are cooking in their trucks or even hiring a trainer.

Others joined the Healthy Truckers Association of America, paying $7.50 a month to belong to an organization that is rapidly growing (see link below to Chicago tribune article). That group now offers truckers a prescription drug card enabling its members to save ~60% on meds.

http://healthytruck.org/node/101

I applaud all these moves; if I'm on the road with a large truck or a series of them, I'd like their drivers to be in shape and wide awake.

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Posted in Complications of Obesity, diabetes type 2, Dieting, Exercise possibilities, Food Choices, Governmental Efforts, Healthly lifestyle, Holiday/travel eating, Obesity, Publications, tricks and gimmicks, Weight Loss | No Comments »

Do our kids have a bleak future?

Saturday, November 19th, 2011

As close to a salad as he'll get

I'm taking a break today from my series of posts on greenhouse gases, alternative energy source, volcanoes and global warming. All of those will affect the generations to come and those now growing up, but I want to re-examine another side of their issues. This morning I read two articles and one newspaper report on the heart health prospects for our American kids (and, by extension, kids elsewhere in the developed/rapidly developing world). The initial article came from a section of the Wall Street Journal I hadn't gotten around to reading yesterday and was about to recycle. Then I saw a title that caught my eye, "Kids' Hearth Health Is Faulted."

I found a CDC website with an explanation of the National Health and Nutrition Examination Survey, NHANES. This is a continuation of a US Public Health Service effort started 40 years ago and is updated annually. Medically-trained interviewers may well come to your town and even to your front door someday. The data they obtain is used in many ways (I'll paste in a website that leads you to some comments on NHANES as well as to a link to a video).

Now a portion of the survey/study looked at 5,450 kids between 12 and 19, finding they were a long ways from matching the American Heart Association's (AHA) seven criteria for idea cardiovascular health (see 2nd link below to Harvard's Beth Israel Deaconess Medical Center's article on the subject). The adult health measures, known as Life's Simple 7, are: 1). Never smoked or quit more than a year ago; 2). Body Mass Index (a measure of height versus weight) <25; 3). Physical activity on a weekly basis for 75 minutes (vigorously) or 150 minutes (moderate intensity).; 4). a healthy diet (four or more components meeting AHA guidelines); 5). total cholesterol <200 mg/dL; 6). blood pressure (BP) <120/80; and fasting blood glucose (AKA blood sugar) <100 mg/dL. The original article was published in the journal Circulation January 20, 2010 and is available free online. The metrics are slightly different for kids.

So where do our kids stack up? If you exclude eating a healthy diet, only 16.4% of boys and 11.3% of girls meet the standards for the other six criteria; if you include diet, none of them do. They don't eat four to five servings of fruits and vegetables a day; they also don't get enough whole-grains or fish and they consume far to much salt and sugar-sweetened drinks. Only one fifth of them even eat "fairly well."

drop that hamburger and run for an hour

Many of then also don't exercise on a daily basis for at least sixty minutes (50% of the boys do and 40% of the girls). More than a third are overweight or obese.

There's some hope: a just-published article in the New England Journal of Medicine, examining the data from four studies following 6328 kids, found that those who do manage to lose weight had lower risk for type 2 diabetes, hypertension, abnormal lipids and carotid artery disease.

So I'm heading to the health club and will read the 2010 Circulation tome on an exercise bike.

Thus far my one biologic grandson, about to be 12,  is physically active and slender. I'll encourage him to stay that way and the non-biologic grandkids to follow his example.

More on this subject to come.

Check out these articles:

Survey Results and Products from the National Health and Nutrition Examination Survey

AHA Defines "Ideal" Cardiovascular Health

 

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Posted in Complications of Obesity, diabetes type 2, Exercise possibilities, Food Choices, Food-related disease, Life Expectancy, medically-oriented background info, our kids and their weight issues, physician initiatives, Publications, strategies for healthy aging, Unhealthy eating | 3 Comments »

Should the kids be in the middle? It may depend on the kid's middle

Tuesday, November 1st, 2011

This is not the example you should set

A Wall Street Journal headline caught my eye, "Obesity Fuels Custody Fights." It noted that childhood obesity is frequently being used by one parent or the other as grounds for custody changes with accusations concerning poor diets and lack of exercise flying back and forth.

That led me to a July 13, 201 article in The Journal of the American Medical Association (henceforth JAMA), "State Intervention in Life-Threatening Childhood Obesity."

We're not talking about mildly overweight kids here; in 2009 a 555-pound fourteen-yer-old boy, living in one of the southeastern states, was taken  by court order from his mother and placed into foster care. She in turn was charged with criminal neglect as the Department of Social Services for that state felt they must intervene or the boy would be at considerable risk for major obesity-related problems, especially diabetes type 2. I found a photo online of the boy and my jaw dropped.

The JAMA article notes "even relatively mild parenting deficiencies" can contribute to a child's weight problems: having junk food in the home, frequently taking the kids to fast food restaurants, failing to model an active lifestyle.The CDC estimates `17% of America's kids and teens are obese (we're not just talking mildly overweight); that's 12.5 million kids at risk. The two Boston authors who wrote in JAMA quote a study showing 2 million of those obese kids are grossly obese with a BMI at or beyond the 99th percentile for their age (a very small percentage of those grossly obese kids, it turns out, may have a genetic abnormality; in those rare cases, the parents aren't to blame).

What can we do about this horrendous problem? Well, there are a variety of "bariatric" operations available in pediatric surgery programs; in dire cases state legal action may be

this makes more sense

necessary. But I liked what I saw the other day walking Yoda, our nine-year-old Tibetan terrier, on his morning constitutional (he gets an evening walk as well, which means either my wife or I or both get some extra exercise).

We came near the elementary school near us and there was a long line of kids, punctuated by an occasional teacher, running past. We stopped to watch, realized these were kindergarden and/or first grade kids, and finally had an opportunity to ask one of the teachers what was going on.

"It's a new program we've started in the Poudre School District," she said. "We keep the kids moving for thirty minutes. They can run and most do, or twirl around and walk the field next to the school, but they've got to keep moving."

The conclusion in the JAMA article was stark, but offered a road to resolution. The authors noted, "An increasing proportion of US children are so severely obese as to be at immediate risk for life-threatening complication including type 2 diabetes." They mentioned the pediatric weight loss surgical programs and state protective services, but finished with our need to decrease the need for those options through beefing up the social infrastructure and policies to improve both kids' diets and guide them toward more physical activity.

Those solutions may work.

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Posted in Complications of Obesity, diabetes type 2, Governmental Efforts, Life Expectancy, medically-oriented background info, Obesity, our kids and their weight issues, Publications, Unhealthy eating | No Comments »

Hypertension: some good news

Tuesday, May 31st, 2011

Let's check your BP

I was reading a blog post from May 2010 written by an unidentified cardiologist. Some of the underlying issues were worth following to better sources. The blog stated that high blood pressure is our most common chronic disease. It went on to mention the connection between BP and weight, saying, as a nation, America is one million tons overweight. It claimed that ten pounds of weight loss could normalize the BP of many Americans.

I initially got into today's data search because of a Wall Street Journal article (Personal Journal; May 31, 2010; pp.D1-2) titled "A Long-Awaited Advance in the War on Blood Pressure." I Googled the author, Ron Winslow and he is the deputy editor for health and science and a senior medical and health care writer for WSJ with over a thousand articles written.

He reported that the American Society for Hypertension (ASH) met in New York last week (May 21-24,2011) and Dr. Brent Eagan, the vice president of ASH, and Professor of Medicine at the University of South Carolina reported some real progress on the multi-state Hypertension Initiative he heads. It's working with ~500 primary care practitioners and over 110,000 hypertensive patients in the Southeast. Nearly 70% of their patient have controlled BPs now (vs. 40% a decade ago).

About as far away as you can get in the U.S., Kaiser Permanente's northern California branch follows >600,000 patients with hypertension and reported at the same ASH meeting that 80% of that group have controlled BP readings compared to 44% ten years back.

One of the Kaiser patients had a regular checkup in 2007 and had mildly elevated BPs then (145/74). Her own comment was, "Here in northern California, we believe in exercise and good nutrition and we're not into pills."

Yet her doctors started her on two medications for hypertension and early this year her BP was 117/74. She's walking three miles three times a week, eating fruits and vegetables and going to a strength-training class at a gym. I don't know if she lost weight also, but I wouldn't be surprised. I mentioned in an earlier post, that my own BP fell markedly after I lost ~25 pounds, and the dosage of the anti-hypertensive drug I've been on for years had to be cut in half.

Guess who's at higher risk for CV disease

So why am I writing about this in a blog devoted mostly to weight/diet/exercise?  First, there's an increased awareness of the association between excess weight, high BP and cardiovascular risk at all ages. An article in the Feb 3, 2009 edition of Circulation looked at the issue in children and adolescents. Concentrating on the Metabolic Syndrome (obesity, diabetes, hypertension, abnormal blood lipids), there was, even in these young people, a definite correlation between the degree of obesity and cardiovascular risk. They stated that strong evidence places obesity as the most significant risk factor

Can I tie all this together? Well I'd say bluntly that obesity is our major enemy, it's a major causal factor in hypertension which is being treated pharmacologically at earlier stages and that diet and exercise are extremely useful ways to combat both entities.


Posted in Complications of Obesity, Hypertension, Life extension, Obesity, Publications, Weight Loss | No Comments »

Brian Wansink's "Mindless Eating" concept

Tuesday, May 24th, 2011

Don't fill your plate this way

I just read Brian Wansink's book, Mindless Eating: Why We Eat More Than We Think. Wansink got a PhD in Consumer Behavior from Stanford and from 2007 to 2009 was the USDA's Executive Director for Nutrition Policy and Promotion. He's currently in an Endowed Chair at Cornell and won the humorous Ig Nobel Prize in 2007.

If you've never heard of the Ig Nobel Prizes, Google the term. They started in 1991 and were originally given for discoveries "that cannot, or should not be, reproduced." They are presented by Nobel laureates in a ceremony  sponsored by three Harvard groups, broadcast on NPR, on the Internet and on Science Friday the day after Thanksgiving. Some are thinly veiled criticism (BP was a co-winner in 2010 for disproving the old belief that oil and water don't mix). Most are for serious work that has a humorous slant (malaria-carrying mosquitoes are equally attracted to the smell of Camembert cheese and human feet; this led to insect traps in Africa being baited with that cheese).

In Wansink's case, his award was given in the Nutrition category for studying people's appetite for mindless eating by secretly feeding them a self-refilling bowl of soup.

His work has focused on how our environment influences our eating habits. Wansink says we all make well over 200 food choices a day (what to eat, what to drink, how much of each) and we rarely know why we make those decisions or if they are helpful/healthy choices.

For instance, one of his experiments showed using smaller plates can help you serve and eat less. Another concerned fat-free foods, which may have nearly as many calories (and sometimes more) than the standard version of the same food item. In one of his studies, normal-weight subjects given low-fat foods actually consumer one-sixth more calories and overweight subjects took in nearly 50% more calories.

Wansink says low-fat foods have a "health halo;" we think they're better for us and therefore, in a sense, give ourselves permission to eat more of them.

Container size is another of his "food trap" areas. When presented with a larger package, a larger bottle of a soda or a short, fat glass to pour a drink into, we end up eating or drinking more.

He suggests a series of food trade-offs and food policies (if I want that doughnut, I need to spend an hour walking; I'll only eat snacks when I'm sitting at the table).

Try eating with these instead of a knife and fork

I liked Wansink's books, already had been using many of his strategies, but found others I can adopt. I think his studies and concepts are valid and his ~300-page publication well worth reading.If you do so, you may find yourself using chopsticks the next time you eat Chinese food. You'll likely eat less per bite and eat slower.

I may try them for American food.

 

Posted in Complications of Obesity, Life Expectancy, medically-oriented background info, Obesity, Publications, strategies for healthy aging, Unhealthy eating, Weight Loss | No Comments »

Today's trail led back nearly five years

Tuesday, May 3rd, 2011

It's time to eat less and do more

There was an interesting article in the Wall Street Journal this morning titled "The Bigger the Belly, the Bigger the Risk." It cited an article published online yesterday in the Journal of the American College of Cardiology with the lead author being a Mayo Clinic (Rochester branch) physician named Francisco Lopez-Jimenez.

I followed the paper trail (that's not exactly correct since it's an online publication) and read the abstract, then another of Dr. Lopez-Jimenez's articles, then a commentary and followed those concepts back to a long article written in 2006 by a Yale staffer, Dr. David L. Katz.

Dr. Katz's article in the Harvard Health Policy Review (Vol. 7, No. 2, Fall 2006, pp.135-151) is one of the best I've ever read and I'll concentrate on it today and then move up to 2011.

Katz gives statistics (remember these are almost five years old) showing at least 15% of kids ages 6 to 19 are overweight with higher percentages for Hispanic and Black children. Then he notes that more than two thirds of kids over 10 who are obese will turn out to be obese as adults. They will then be subject to the big three obesity-relayed diseases, diabetes, heart disease and cancer. And while they are children, their quality of life is less, for many reasons.

What I didn't realize was even those who lose weight as adults, but were obese as kids, are at increased risk.

Not the right choice for weight loss

He goes on to explain that as a species, we ate, historically, when we could, stored fat for times when food was scarce, and exercised a lot. All that has changed, but we still tend to eat more than we should, given the fact that for many of us food is abundant. And our modern labor-saving devices mean we usually exercise far less than we should. We also eat the wrong things. The end result is weight gain, to the point of frank obesity for many.

Today's article said where you carry excess weight is more important than the sheer fact of being overweight. I read several of Dr. Lopez-Jimenez' publications, and their main thrust is that central obesity, i.e., having a large roll around your waistline, is much more detrimental than simply having a higher than usual weight or BMI.

Lopez-Jimenez and his co-authors looked at studies following patients with heart disease, but other papers support their basic theme. The NIH's director of cardiovascular sciences, Dr. Michael Laurer, who wasn't involved in the Lopez-Jimenez study, is quoted as saying, "Fat is not created equal and where fat is located makes a difference."

The other comment that was somewhat new also came from Dr. Laurer who said, "Fat isn't an inert substance." Apparently scientists have found a number of toxic chemicals can be released from fat.

I'm heading to the gym next where I'll see a number of men in the locker room who have built up their upper body muscles, but have a considerable roll around their mid-section. They need to adopt a new exercise, pushing away from the dinner table.

 

Posted in Complications of Obesity, medically-oriented background info, Obesity | No Comments »

Saving $1T by losing pounds

Saturday, April 16th, 2011

whole-grain cereal and a banana

Mark Bittman's "Opinionator" column in the New York TImes April 12, 2011, was right on. He called the $36B that Congress has been haggling over (like two small boys) small potatoes compared to what could be saved if we ate less overall and ate more of the right things. He quoted a number of medical resources, so I went back to look at the originals.

In the January 24, 2011 online edition of the American Heart Association's journal Circulation, a panel headed by a Stanford Associate Professor, Paul Heidenreich, stated that cardiovascular disease (CVD) currently accounts for more than one sixth of all US health dollars spent. They went on to predict that by 2030 the direct costs of care for all forms of CVD would triple from a 2010 estimate of $273B to $818B .

CVD includes stroke, heart attacks, congestive heart failure and hypertension among other entities and they are often highly correlated. In fact the INTERHEART study which Bittman quotes (and I found in a seven-year-old copy of the journal Lancet), says lifestyle-related risk factors such as obesity, smoking and hypertension account for roughly 90+% of heart disease.

We haven't even started on Type 2 diabetes (DM) yet and Bittman noted that problem will cost roughly $500B per year  by 2020. And almost all of the cases of Type 2 DM are preventable.

If we want to reduce the deficit, one way would be to reduce our weights and trim our waistlines. Sure, we wouldn't get rid of all CVD and Type 2 DM, but a large share of the $1.3T per year we will be spending on them by 2020-2030 could be avoided.

We're spending over $2T a year now on healthcare and those costs are going up and up.

So how can we save a major chunk of that huge sum? How about Dr. David Ludwig's ideas? He's a Harvard doc who has worked with Marion Nestle, the PhD dietitian I've mentioned before. He published a very recent article in JAMA (the Journal of the American Medical Association) with both straightforward and complex/innovate modalities to improve our American diet.

I read something about Dr. Ludwig and his earlier concepts in his Harvard bio and a WebMD interview. He's a pediatric endocrinologist working at Children's Hospital in Boston, founding director of its Optimal Weight for Life (OWL) program and author of Ending the Food Fight:Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World.

In the JAMA article he talks about better funding for school lunch programs, making breads with whole grains (non-refined) and research needed to improve food preservatives that are healthier than the current ones. His own studies appear to show a correlation between lower calorie intake and eating whole grain products.

I see two difficult issues: getting people to make healthy foods choices and avoiding bureaucratic costs as the British experienced from their NHS shift toward paying physicians for preventive measures (NB. WSJ article from 4-16-2011 p. C3).

But what a great way to save us money that Congress might even agree on.

 

 

 

 

Posted in Complications of Obesity, Dieting, Healthy eating, Life extension, medically-oriented background info, Obesity, Weight Loss | No Comments »

Which came first: the diabetic chicken, the obese egg or the depressed farmer?

Saturday, February 26th, 2011

The chicken and the egg

My wife is a Mental Health therapist, attended a conference recently & then got an email from the presenter which referred to a study linking diabetes and depression. I got the synopsis from the Web and then went to our local hospital library where I could get a copy of the article. I'll come back to it later, since it was a new twist on the familiar entity .

the depressed farmer

Firstly, in spite of my post's title, this is no joking matter. I found a World Health Organization (WHO) fact sheet dated January 2011 on diabetes: It's a worldwide epidemic with more than 220 million suffering from the disorder and its consequences including an estimated 3.4 million deaths a year. If you're diabetic your chance of dying at a given age is twice that of your peers. If you are diabetic for fifteen years, you have a 2% chance of being blind and a 10% possibility of having severe visual impairment. Ten to twenty percent of diabetics die of kidney failure and then, of course, there's heart disease and stroke and amputations from diabetic vascular disease.

Next I found a medical article with stark  statistics: in 2007 about 2.6% of the US population aged 20-39 had diabetes, 10.8% of those aged 40 to 59 and 23.1% of those over 60. Diabetes and its complications consume 14% of the US health dollar and we're fairly high up there in the list of countries having a significant prevalence of the disease. Lowest on the WHO list was Iceland at 2% and highest was Saudi Arabia with 13+% of those who are 20 to 79 years old being diabetic.

There is a strong correlation between diabetes type 2 & excess weight, especially among women. That association is 80% or higher in Europe, Latin America and North America according to still another article.

And, as you might expect, eating a healthy diet, getting regular physical activity, maintaining a normal body weight and not smoking are the basic of diabetes prevention. By the way, 90% of diabetics around the world have type 2 disease, resulting from the body's ineffective use of insulin.

So what's the new angle? I already knew that half of all diabetics die from cardiovascular diseases, incluing heart attacks and stroke. I didn't know the odds were considerably worse for women with both diabetes and depression. The article I had printed off followed over 55,000 women for ten years (1996-2006) as part of the Nurses' Health Study. There were strong correlations between diabetes and depression in this study performed by researchers from Harvard, the University of Singapore and two English medical schools. Another professor, this one from Indiana, stated that over the past twenty years they'd learned that people with diabetes are twice as likely to suffer from depression as those who don't have the disease.

The Harvard group, in another article, state that death risk is three times as great if a person has both diabetes and depression. The two diseases appear to be linked; the question of antidepressant drugs being associated with an increased risk of diabetes was raised, but causation is unclear at present.

So once more, eat well, stay slim, exercise and be happy; it's good for your health.

Posted in Complications of Obesity, Exercise possibilities, Life Expectancy, medically-oriented background info, Obesity | 5 Comments »

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